Hypothesis Fibrinaloid Microclots and Atrial Fibrillation, 2024, Kell, Lip, Pretorius

Fibrinaloid Microclots and Atrial Fibrillation
Kell, Douglas B.; Lip, Gregory Y. H.; Pretorius, Etheresia

Atrial fibrillation (AF) is a comorbidity of a variety of other chronic, inflammatory diseases for which fibrinaloid microclots are a known accompaniment (and in some cases, a cause, with a mechanistic basis). Clots are, of course, a well-known consequence of atrial fibrillation.

We here ask the question whether the fibrinaloid microclots seen in plasma or serum may in fact also be a cause of (or contributor to) the development of AF. We consider known ‘risk factors’ for AF, and in particular, exogenous stimuli such as infection and air pollution by particulates, both of which are known to cause AF. The external accompaniments of both bacterial (lipopolysaccharide and lipoteichoic acids) and viral (SARS-CoV-2 spike protein) infections are known to stimulate fibrinaloid microclots when added in vitro, and fibrinaloid microclots, as with other amyloid proteins, can be cytotoxic, both by inducing hypoxia/reperfusion and by other means. Strokes and thromboembolisms are also common consequences of AF.

Consequently, taking a systems approach, we review the considerable evidence in detail, which leads us to suggest that it is likely that microclots may well have an aetiological role in the development of AF. This has significant mechanistic and therapeutic implications.

Link | PDF (Biomedicines) [Open Access]

 

A couple of cheeky comments* — "It's turtles microclots all the way down"; alternatively "Everything's coming up Milhouse microclots."

I also chuckled at the mind-map, which I think could otherwise have been called a "circular table of contents"



* Of course, if the theory's correct, this will all be a medical game-changer.

 

Some abbreviated passages —

Highlighting here that amyloid and the amyloid stains were a later finding, initially microclots were seen under the electron microscope as "dense matted deposits".

 

I am trying very hard to take the micro clot story seriously and the work from Caroline Dalton makes it look as if there may actually be some underlying shift in plasma protein basis to these findings, even if not actually micro clots in vivo. But this reads like someone who has lost the plot entirely. It is sort of 'maybe there are aliens on Mars, so maybe there are aliens in your fridge too'.
A bit like Linus Pauling deciding that germs come from space.

 

And what exactly are, or is, 'Biomedicines' - the name of the journal?
I think I understand what biomedicine means as a wide area of study that includes biology relevant to medicine, but what does the plural 'biomedicines' mean?

Are there treatments called 'biomedicines' like antibiotics perhaps?
But this paper has nothing to do with them if there are it seems.

Is the word simply as meaningless as possible to make it clear that it is a journal that will happily accept, for a fee, papers that are as meaningless as possible?

 

Yes I had the same response when looking at previous articles from this journal - it's an odd name. FWIW Impact factor is 4.7, so reasonable. None of the papers I've downloaded have earned 4 or 5 stars from me and there are a few 1 and 2 star papers, so a mixed bag in my view. Anyway from the journal's about page —

This paper does reference their other recent preprint looking at nattokinase which might fit the journal's interest: Automated microscopic measurement of fibrinaloid microclots and their degradation by nattokinase, the main natto protease (2024, Preprint: BioRxiv) - currently an initial post only thread.

Off-topic for this thread, but just to note —

According to the editors page, the current editor-in-chief has interests in neuromodulation; pain perception modulation; neurophysiology; neuroplasticity and was senior author of an editorial on fibromyalgia (in another journal of which he's editor in chief and founder) Physical Conditioning, Obesity and Fibromyalgia:Causal Relationship or Confounding? (2024, Principles and Practice of Clinical Research). It concludes —

 

Which is worth absolutely nothing, please note!

 

an open access journal devoted to all aspects of research on human health and disease, the discovery and characterization of new therapeutic targets, therapeutic strategies, and research of naturally driven biomedicines, pharmaceuticals, and biopharmaceutical products. Topics include pathogenesis mechanisms of diseases, translational medical research, clinical studies and applications, biomaterial in biomedical research, natural bioactive molecules, biologics, biosimilar, vaccines, gene therapies, cell-based therapies, targeted specific antibodies, recombinant therapeutic proteins, nanobiotechnology-driven products, targeted therapy, bioimaging, biosensors, biomarkers, biosimilars, and nano-biosimilars.

In other words whoever thought up the name hasn't a clue what it is supposed to mean and is just touting for as much income as possible. It bears about as much relation to what journals used to be a bout as a 'Rolex' from a Chinese online source.

 

Hasn't a clue, as I said.

 

I just cannot see any motivation for a serious scientists to write an article like this in a journal like this - or anywhere. At least not an academic motivation.

 

This focus on obesity as "causal or confounding" for FM is a bit disingenuous.

References listed in the paper about FM and obesity are many and include one that states (International Rheumatology) that 40% of FM patients are obese (and 30% are overweight). Not sure which country or countries this refers to. And a recent WHO report (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107388/) stated that 59% of adults in Europe were either obese or overweight.

According to the CDC office of health statistics, 41.9% of US adults (2017-2020) were obese.